SOMA CARE, LLC (NPI# 1447864202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447864202 |
| Entity Type | Organization |
| Organization Name | SOMA CARE, LLC |
| Practice Address |
6944 E Broadway Rd Ste A Mesa AZ 85208-1916 |
| Practice Telephone | 4805507460 |
| Practice Fax Number | 4804592805 |
| Mailing Telephone | 4805507460 |
| Mailing Fax Number | 4804592805 |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | RICHARD WADE (DNP/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 4805507460 |
| Authorized Official Credential | DNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6944 E BROADWAY RD STE A |
| City | MESA |
| State | AZ |
| Zip Code | 85208-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588203723 | Southwest Cardiovascular Interventional Center, LLC | Clinic/Center | 7529 E Broadway, Mesa, AZ 85208 | 2020-01-06 |
| 1760021802 | Southwest Endovascular Center, LLC | Clinic/Center | 7529 E Broadway Rd, Mesa, AZ 85208 | 2020-01-06 |
| 1083116529 | Hailey Jo Kools | Specialist/Technologist | 11201 N Tatum Boulevard, Phoenix, AZ 85208 | 2018-03-01 |
| 1356881486 | Amber E Anderson | Nurse Practitioner | 1157 S Crismon Rd Ste 101, Mesa, AZ 85208 | 2017-03-08 |
| 1609264464 | Desert House Assisted Living LLC | Assisted Living Facility | 11055 E Grove St, Mesa, AZ 85208 | 2015-01-02 |
| 1366881872 | Freedom Az, LLC | Non-emergency Medical Transport (VAN) | 10682 E Oasis Dr, Mesa, AZ 85208 | 2013-06-18 |
| 1588922884 | Aaron David Hallstrom | Counselor | 158 S Hassett Cir, Mesa, AZ 85208 | 2012-04-25 |
| 1568604593 | David Berrey | Internal Medicine | 1917 South Crismon Rd., Mesa, AZ 85208 | 2009-04-06 |
| 1740475946 | Jackton Simiyu Khausi | Occupational Therapist | 7255 E Broadway, Mesa, AZ 85208 | 2007-09-11 |
| 1881896900 | Kate N Mullowney | Pharmacist | 10238 E Hampton Avenue, Suite 107, Mesa, AZ 85208 | 2007-06-01 |
| Find all providers in zip 85208 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487149 | Sunitha Jose | Nurse Practitioner | 3308 N Higley Rd, Mesa, AZ 85215-9781 | 2020-08-10 |
| 1447877972 | Reena Pathak | Nurse Practitioner | 1111 S Stapley Dr # 5060, Mesa, AZ 85204-5059 | 2020-07-01 |
| 1760021885 | Matthew Deise | Nurse Practitioner | 460 N Mesa Dr Ste 201, Mesa, AZ 85201-5957 | 2020-01-06 |
| 1639713621 | Summit Place Mental Health, LLC | Nurse Practitioner | 625 W Southern Ave Ste E, Mesa, AZ 85210-5018 | 2019-11-01 |
| 1063062149 | Makenna Francis | Nurse Practitioner | 2730 S. Val Vista Dr, 146, Mesa, AZ 85215 | 2019-09-19 |
| 1891341947 | James M Theiss | Nurse Practitioner | 5439 E Ellis St, Mesa, AZ 85205-5470 | 2019-08-14 |
| 1134527534 | Susan Willever | Nurse Practitioner | 11331 E Starfire Cir, Mesa, AZ 85212-7062 | 2014-12-17 |
| 1326443003 | Jennifer Anderson | Nurse Practitioner | 6262 E Brown Rd Unit 43, Mesa, AZ 85205-4846 | 2014-10-24 |
| 1356616205 | Sukanlaya Hughes | Nurse Practitioner | 2444 E. Southern Ave. Ste. 103, Mesa, AZ 85204 | 2012-03-11 |
| 1942403076 | Shosamana | Nurse Practitioner | 3740 E Southern Ave Ste 207, Mesa, AZ 85206-2512 | 2007-06-06 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.